QUEBEC CITY — Noninvasive methods for identifying pediatric diabetic neuropathy are not as sensitive as conventional nerve conduction studies and should not be considered for screening purposes, Daniele Pacaud, M.D., said at the joint annual meeting of the Canadian Diabetes Association and the Canadian Society of Endocrinology and Metabolism.
Her study compared vibration perception thresholds (VPT) and tactile perception thresholds (TPT) with nerve conduction studies (NCS) in 73 children, mean age 13 years, with type 1 diabetes.
For VPT testing, subjects were asked to touch a box with their big toe and to indicate if it is vibrating. The amplitude of the vibrations is steadily decreased until they become imperceptible.
For TPT, subjects were asked to indicate when they feel microfilaments that are applied to the plantar surface of the foot.
All children in the study completed a neurologic questionnaire, underwent NCS, and received a neurologic exam. Based on two abnormalities on NCS, diabetic neuropathy was present in 42 (57%) of the 73 subjects.
Of these, 37 were picked up by VPT, 26 by neurologic exam alone, and 19 by TPT, said Dr. Pacaud, of Alberta Children's Hospital and the University of Calgary in Calgary (Alta.). The neurologic symptoms questionnaire was not useful, she added.